Substitute Addictions

Theories

One theory that addresses substitute addiction issues is the self-regulation systems model, where the current state experienced and set point on arousal or affect are chronically apart. This theory points out that biological factors, such as neurotransmitter imbalances, as well as problems with cognitive development, may lead individuals to self-regulate or "balance" their mood using substances or other behaviors that may be considered addictions.

Bidirectional theory contends that substance use and abuse occur when coping strategies to remain sober fail, mainly because of a combination of psychological and sociological factors that impact an individual. This theory implies that outside factors, such as income, community resources, and family support systems, as well as psychological factors, such as cognitive and internal demands, influence a person to seek substances or other addictions as a way of coping with stressful events.

A biological basis for substitute addictions can be explained by the lack of dopamine receptor sites within the brain. Dopamine is the chemical within the human brain that provides pleasure. When psychoactive or illicit drugs are introduced into the body, dopamine receptors are stimulated and individuals feel pleasurable sensations. After an individual has been using drugs for extended periods of time, the brain adapts to the increase in dopamine by reducing the receptor sites in the brain where dopamine chemical reactions take place, known as the neural synapse. Because there are fewer receptor sites in the brain because of prolonged drug use, an individual often experiences depression and feelings of lethargy because dopamine uptake is restricted.

Substitute addictions may be adopted to stimulate dopamine production for many individuals because the substitute behavior produces dopamine and therefore elicits feelings of pleasure for the individual. For example, eating food stimulates dopamine, as does having an orgasm or exercising vigorously. Although the previous examples do not stimulate as much dopamine in the brain as do most illicit drugs, the effect is still one of positive reinforcement.

Treatment

Educational approaches may help clients become aware of the dangers of substituting addictions. During treatment, it is important for providers to assess the probability of a client developing a substitute addiction by reviewing the psychosocial history and other information gathered during treatment. The issue of substitute addictions can be discussed with the client and the client's significant others and included in the relapse prevention plan. In addition, the client and the client's significant others should be informed of the symptoms of a substitute addiction and guided to seek immediate assistance if they see evidence of a substitute addiction.

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